Rectal Examination
1. Explain what the procedure will involve and gain consent
2. Ask the patient if they would like a chaperone to make them a bit more comfortable
3. Ask the patient to undress from the waist down, and lie at the edge of the bed on their left side with their
knees up – there’s a blanket to keep you bit warmer and covered up
4. Wash hands
5. Apply gloves and apron
6. Remove gown/blanket to expose peri-anal area
7. Inspect for: (you will have to separate the cheeks – ask the patient if they can feel this both sides (cauda equina))
- Haemorrhoids
- Abscesses
- Bleeding
- Fissures
- Fistulae
- Prolapsed rectal mucosae
8. Lubricate your finger with lots of jelly (let the patient know you’re doing this)
9. “I’m going to insert my finger now, it might be a bit cold from the jelly” let me know if you’re in any pain
10. Place finger on sphincter first to relax, then insert gently
11. Rotate finger 360degrees – rectal wall should feel smooth and pliable
- Prostate will be anterior – expect smooth, cleft-y mass (not craggy or uneven cleft-y lumps)
12. Check anal tone by asking the patient to squeeze your finger
13. Remove finger gently
14. Inspect glove and wipe glove on gauze – inspect this obviously
- Blood
- Mucus
- Stool
15. Clean patient with gauze or tissue and put gown/blanket back over
16. Remove gloves, wash hands
17. Inform patient the examination is complete, “I’ll let you get dressed”
To complete the procedure:
- I would like to take a full medical history
- I would like to perform a full abdominal examination
Clinical findings:
- 12 ‘o’ clock = forwards
- 6 ‘o’ clock = behind
1. Explain what the procedure will involve and gain consent
2. Ask the patient if they would like a chaperone to make them a bit more comfortable
3. Ask the patient to undress from the waist down, and lie at the edge of the bed on their left side with their
knees up – there’s a blanket to keep you bit warmer and covered up
4. Wash hands
5. Apply gloves and apron
6. Remove gown/blanket to expose peri-anal area
7. Inspect for: (you will have to separate the cheeks – ask the patient if they can feel this both sides (cauda equina))
- Haemorrhoids
- Abscesses
- Bleeding
- Fissures
- Fistulae
- Prolapsed rectal mucosae
8. Lubricate your finger with lots of jelly (let the patient know you’re doing this)
9. “I’m going to insert my finger now, it might be a bit cold from the jelly” let me know if you’re in any pain
10. Place finger on sphincter first to relax, then insert gently
11. Rotate finger 360degrees – rectal wall should feel smooth and pliable
- Prostate will be anterior – expect smooth, cleft-y mass (not craggy or uneven cleft-y lumps)
12. Check anal tone by asking the patient to squeeze your finger
13. Remove finger gently
14. Inspect glove and wipe glove on gauze – inspect this obviously
- Blood
- Mucus
- Stool
15. Clean patient with gauze or tissue and put gown/blanket back over
16. Remove gloves, wash hands
17. Inform patient the examination is complete, “I’ll let you get dressed”
To complete the procedure:
- I would like to take a full medical history
- I would like to perform a full abdominal examination
Clinical findings:
- 12 ‘o’ clock = forwards
- 6 ‘o’ clock = behind
